Debbie Rigby takes a look at the latest in research news
Penicillin allergy is commonly reported, but 9 out of 10 times, penicillin will be tolerated if administered. Reasons for this include mislabelling intolerances as allergies and waning of immunoglobulin E–mediated allergy over time. Penicillin allergy is lost over time, with resolution in 80% of people over 10 years, and in 50% over 5 years.
CMAJ 2019 February 25;191:E231.
Prospective cohort analysis of over 130,000 participants shows HMR use over a 5-year period was generally below 10%, even in high-risk groups. HMR use was 1.5% in people using <5 medications at baseline, 6.8% with 5–9 medications, 12.7% with ≥10 medications, 8.8% using Narrow Therapeutic Index medicines, 6.8% using Beers Criteria potentially inappropriate medicines and 7.4% using DBI medicines. The authors suggest substantial potential for improvement in uptake and targeting.
BMJ Open 2019;9:e027305.
A systematic review and meta-analysis of individual participant data from 4 randomised controlled trials (n=560) shows vitamin D supplementation safely and substantially reduced the rate of moderate/severe COPD exacerbations in patients with baseline 25-hydroxyvitamin D levels <25 nmol/L but not in those with higher levels.
Antibiotic allergy labels (AALs), reported by up to 25% of hospitalized patients, are a significant barrier to appropriate prescribing and a focus of antimicrobial stewardship (AMS) programs. A prospective audit at Austin Health has shown inpatient oral rechallenge led to 95.2% of patients with a documented penicillin allergy successfully had their penicillin AAL removed.
Journal of Antimicrobial Chemotherapy, 2019.